Neonatal Medicine Department, Federal University of Health Sciences of Porto Alegre, Consultant Neonatologist at Hospital Moinhos de Vento, Porto Alegre, Brazil.
Neonatal Intensive Care Unit, Hospital Moinhos de Vento, Porto Alegre, Brazil.
Breastfeed Med. 2024 Jun;19(6):483-489. doi: 10.1089/bfm.2023.0266. Epub 2024 Apr 17.
Mother's own milk (MOM) provides health benefits for infants with very low birth weight (VLBW). This study aimed to describe the incidence and factors associated with low volumes of MOM (<50% of total diet volume) at discharge for VLBW infants. A prospective cohort study of infants with VLBW and gestational age of <30 weeks, who survived to discharge and had no contraindication to MOM. We conducted bivariate analyses to investigate associations with the volume of MOM at discharge, using chi-square, , and Mann-Whitney tests. All -value analyses were two-tailed. The variables significantly associated with "low volumes of MOM" entered the multivariable analysis. Univariate and multivariate relative risk (confidence interval [CI] 95%) estimates were obtained from Poisson regression with a robust estimate of variance and controlled by the length of hospital stay. Of 414 infants included and followed until discharge, 32.9% ( = 136) received less than 50% of the total daily volume of MOM. This outcome was associated with gestational age <28 weeks, lower birth weight, multiple births, developing bronchopulmonary dysplasia, and longer lengths of stay. After Poisson regression, low volumes of MOM at discharge were associated only with being born multiples (RR 2.01; CI 95% 1.53-2.64, < 0.001) and with longer length of stay (RR 1.07; CI 95% 1.01-1.14, = 0.01). Most VLBW infants were discharged home receiving predominantly MOM. Each neonatal intensive care unit (NICU) should acknowledge which clinical characteristics of mothers and VLBW infants are associated with difficulties maintaining MOM volumes until discharge.
母亲的自身母乳（MOM）为极低出生体重（VLBW）的婴儿提供健康益处。本研究旨在描述极低出生体重婴儿出院时母乳量（<50%总饮食量）低的发生率和相关因素。这是一项对胎龄<30 周、存活至出院且无母乳喂养禁忌证的 VLBW 婴儿进行的前瞻性队列研究。我们进行了单变量分析，使用卡方检验、检验和曼-惠特尼检验来探讨与出院时母乳量的关系。所有 -值分析均为双侧。与“母乳量低”显著相关的变量进入多变量分析。使用泊松回归获得单变量和多变量相对风险（95%置信区间 [CI]）估计值，并通过住院时间进行控制。在纳入并随访至出院的 414 名婴儿中，32.9%（=136）接受的每日总母乳量不足 50%。这一结果与胎龄<28 周、出生体重低、多胎妊娠、支气管肺发育不良以及住院时间延长有关。经过泊松回归分析，出院时母乳量低仅与多胎妊娠（RR 2.01；95%CI 1.53-2.64，<0.001）和住院时间延长（RR 1.07；95%CI 1.01-1.14，=0.01）有关。大多数极低出生体重婴儿出院时主要接受母乳喂养。每个新生儿重症监护病房（NICU）都应认识到哪些母亲和 VLBW 婴儿的临床特征与维持母乳喂养量直至出院有关。
